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A Retrospective Comparison of Interscalene Block and General Anesthesia for Ambulatory Surgery Shoulder Arthroscopy
  1. John G. D’Alessio, M.D.*,
  2. Martin Rosenblum, M.D., Ph.D.,
  3. Kevin P. Shea, M.D. and
  4. David G. Freitas, M.D.
  1. *Department of Anesthesiology, University of Tennessee, Memphis
  2. Department of Anesthesiology, University of Connecticut School of Medicine, Farmington, Connecticut.
  3. Department of Orthopaedics, University of Connecticut School of Medicine, Farmington, Connecticut.
  1. Reprint requests: John G. D’Alessio, M.D., Department of Anesthesiology, University of Tennessee, Memphis, 800 Madison Avenue, FG-029, Memphis, TN 38163.

Abstract

Background and Objectives An increasing percentage of all surgery is performed in an ambulatory surgery setting. Concurrently, arthroscopy of the shoulder joint has allowed definitive repair of shoulder pathology to occur in this environment. This study was designed to ascertain whether interscalene block is reliable and efficient for use in same-day surgery compared with general anesthesia for shoulder arthroscopy.

Methods The authors retrospectively reviewed patients treated at the University of Connecticut over a 42-month period in the same-day surgery unit. Of 263 patients, 160 had a general anesthetic and 103 had an interscalene block. All times recorded for the study were contemporaneously logged into the operating room computer data base from which they were extracted. Data on complications were retrieved from individual patient charts and hospital quality assurance files.

Results Compared to general anesthesia, regional anesthesia required significantly less total nonsurgical intraoperative time use (53 ± 12 vs. 62 ± 13 minutes, P = .0001) and also decreased postanesthesia care unit stay (72 ± 24 vs. 102 ± 40, P = .0001). Interscalene block anesthesia resulted in significantly fewer unplanned admissions for therapy of severe pain, sedation, or nausea/vomiting than general anesthesia (0 vs. 13, P = .004) and an acceptable failure rate (8.7%).

Conclusions Interscalene block should be considered as a viable alternative to general anesthesia for shoulder arthroscopy in ambulatory surgery patients.

  • ambulatory surgery
  • anesthetic techniques
  • interscalene block
  • general anesthesia
  • postoperative complications
  • same-day surgery
  • shoulder arthroscopy

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Footnotes

  • All work was performed at the University of Connecticut School of Medicine.

    Presented in part at the 67th International Anesthesia Research Society Congress, San Diego, California, 1993.

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